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Green's pastor says she had been hospitalized with emotional problems once before and recently appeared to be in distress again. So the pastor called 911, a decision that haunts her.

Upon her admission, Green waited nearly 24 hours for treatment, said the New York Civil Liberties Union, which released the surveillance video of the incident Tuesday.

Her collapse came at 5:32 a.m. June 19, the NYCLU said, and she stopped moving at 6:07 a.m. During that time, according to the organization, workers at the hospital ignored her.

At 6:35 a.m., the tape shows a hospital employee approaching and nudging Green with her foot, the group said. Help was summoned three minutes later. Watch the surveillance video »

In addition, the organization said, hospital staff falsified Green's records to cover up the time she had lain there without assistance.

"Contrary to what was recorded from four different angles by the hospital's video cameras, the patient's medical records say that at 6 a.m., she got up and went to the bathroom, and at 6:20 a.m. she was 'sitting quietly in waiting room' -- more than 10 minutes since she last moved and 48 minutes after she fell to the floor."

The medical examiner's office says it is still trying to determine what caused Green's death. Her medical records will be the focus of an investigation. Hospital documents say she was "awake and sitting quietly" at the very moment she was actually struggling on the floor.

The New York City Health and Hospitals Corporation, which oversees the hospital, released a statement Tuesday saying it was "shocked and distressed by this situation. It is clear that some of our employees failed to act based on our compassionate standards of care."

James Saunders, a spokesman for the corporation, said seven employees have been fired or suspended: the chief of psychiatry, chief of security, a doctor, two nurses and two security guards.

A Health and Hospitals Corporation spokeswoman said it was aware of the discrepancies in Green's record when it began the preliminary investigation June 20.

The corporation pledged to put "additional and significant" reforms in place in the wake of the death.

A federal investigation is also under way, looking into abuse allegations at Kings County that were detailed in a lawsuit in 2007.

In May 2007, the New York Civil Liberties Union and the Mental Hygiene Legal Service sued Kings County in federal court, alleging that conditions at the facility are filthy. Patients are often forced to sleep in plastic chairs or on floors covered in urine, feces and blood while waiting for beds, the groups allege, and often go without basic hygiene such as showers, clean linens and clean clothes.

The lawsuit claims that patients who complain face physical abuse and are injected with drugs to keep them docile.

The hospital, the suit alleges, lacks "the minimal requirements of basic cleanliness, space, privacy, and personal hygiene that are constitutionally guaranteed even to convicted felons."

Among the reforms agreed to in court Tuesday by the hospital are additional staffing; checking of patients every 15 minutes; and limiting to 25 the number of patients in the psychiatric emergency ward, officials said.

In addition, the hospital said it is expanding crisis-prevention training for staff; expanding space to prevent overcrowding; and reducing patients' wait time for release, treatment or placement in an inpatient bed.